Report Sexual Harassment or Interpersonal Violence to the Title IX Office

Reporter Information

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Your full name:

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You may write Anonymous unless you are an employee with reporting obligations.

Your role at JCU:

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Possible roles include: student, staff, faculty, and volunteer

Your phone number:

Your email address:

Email address must be of a valid format.

Date of incident(Required):

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Time of incident:

Location of incident(Required):

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Specific location:

Involved Parties

Name or Organization

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Phone number

Email address

Hall/Address

Questions

Please describe the details of the incident(s) or concern(s). Focus on the Who, What, Why, When, and How. Indicate specific words, phrases, and interactions.(Required) This field is required.

If you are a Responsible Employee, Witness, or Third-Party Reporter, did you ask the Complainant (person targeted by the behavior) if they wish to make a formal complaint requesting that the University take some action?(Required)

Yes, and they said that they would like to do so. Yes, and they said that they would NOT like to do so at this time. Yes, and they are unsure. No, I did not tell them about the option to file a formal complaint. Not Applicable

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All reports will be handled with concern for the privacy of those filing reports and those identified in the report. However, the Title IX reporting system is NOT a confidential reporting option. Your completed form will be sent directly to the University’s Title IX Coordinator. Confidential reporting options are reports made to individuals who, because of their professional status, are prohibited by law from revealing a reporting person’s identity or facts of a conversation, unless an imminent threat to the individual or others exists. JCU has a number of confidential reporting sources available to members of the University community, including the University Counseling Center, the University Health and Wellness Center (including Doctors or Nurses acting under a Doctor’s direction), ordained members of the clergy engaged in pastoral counseling, or the licensed providers available through the University’s employee assistance program. If you wish to make a confidential report, please report the issue to a confidential reporting option. These confidential reporting options can discuss options available to you for reporting in a non-confidential manner, such as the Title IX Reporting System, if you wish to do so.(Required)

I understand that this report will be sent directly to the University's Title IX Coordinator.

You must make at least one selection.

I understand that this report will only be reviewed during normal business hours, Monday - Friday 8:30 AM to 5:00 PM, and are not monitored after hours, on weekends, or during official University holidays. If I believe there is an immediate risk of harm to self or others, I will call 911 or the John Carroll University Police Department at (216) 397-1234 prior to submitting this report.(Required)

I understand that this report will only be reviewed during normal business hours.

You must make at least one selection.

Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report

Reporter Information

Involved Parties

Questions

Supporting Documentation

Submission